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Breathing polluted air is never wise for anyone, but pregnant women may pay an especially unwanted price.

Dr Mueller said: 'The science on the health effects of air pollution is under review by the EPA.

For the study, researchers looked at almost 1,300 mothers and their babies from the Boston area.

Mueller said, "We believe that when pregnant women breathe air with high levels of fine particulate matter, it causes an inflammatory response that alters genetic expression and foetal growth and development on the pathway to high blood pressure in childhood".

Direct exposure to fine air pollution (PM2.5) was associated with high blood pressure in both children and adults in previous studies, and is a serious cause of illness and premature death worldwide.

High blood pressure typically occurs in adulthood, so when children develop the condition, it often means something is very wrong.

Air pollution levels were calculated for the residential addresses of the mothers using data from the Environmental Protection Agency's (EPA) air quality monitor for each trimester.

Noel Mueller, assistant professor at Johns Hopkins University in the USA and senior author of the study published in the journal Hypertension, said, "Ours is one of the first studies to show breathing polluted air during pregnancy may have a direct negative influence on the cardiovascular health of the offspring during childhood".

The new findings lend support for maintaining, if not strengthening, air pollution standards set under the U.S. Clean Air Act, he said.

"Despite the limitations, Zhang and the Boston Birth Cohort investigators have imaginatively made the most of pediatric data in a disadvantaged urban setting to understand environmental influences on an important physiologic health outcome, blood pressure".

Each 5 ug/m3 increase in PM 2.5 exposure in the womb was associated with a 3.39 percentile increase in what's known as systolic blood pressure, the "top number" that represents the pressure blood exerts against artery walls when the heart beats.

Specifically, the researchers looked for concentrations of PM2.5.

Air pollution exposure during pregnancy, hypertension in children.

The findings suggest that children exposed to higher levels of ambient fine-particulate pollution in the womb during the third trimester were 61 per cent more likely to have elevated systolic in childhood compared to those exposed to the lowest level.

"If maternal and early life pollution exposures increase the long-term risk of high blood pressure, then reducing early-life pollution exposure through regulation and through local and regional efforts may help protect children from having higher blood pressure in childhood, and may improve long term cardiovascular and cerebrovascular health", Dr. Diane Gold, author of an accompanying editorial and a professor at the Harvard T.H. Chan School of Public Health in Boston, said by email.

This provided evidence of the significant impact of in-utero exposure. In 2017, the American Academy of Pediatrics updated its guidelines for screening and managing high blood pressure in youth.